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首页> 外文期刊>World Journal of Gastroenterology >Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: A case report and literature review
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Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: A case report and literature review

机译：内镜超声引导下细针穿刺细胞学诊断胰腺实性假乳头状瘤1例并文献复习

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摘要

We describe the clinical, imaging and cytopathological features of solid pseudopapillary tumor of the pancreas (SPTP) diagnosed by endoscopic ultrasound-guided (EUS-guided) fine-needle aspiration (FNA). A 17-year-old woman was admitted to our hospital with complaints of an unexplained episodic abdominal pain for 2 mo and a short history of hypertension in the endocrinology clinic. Clinical laboratory examinations revealed polycystic ovary syndrome, splenomegaly and low serum amylase and carcinoembryonic antigen (CEA) levels. Computed tomography (CT) analysis revealed a mass of the pancreatic tail with solid and cystic consistency. EUS confirmed the mass, both in body and tail of the pancreas, with distinct borders, which caused dilation of the peripheral part of the pancreatic duct (major diameter 3.7 mm). The patient underwent EUS-FNA. EUS-FNA cytology specimens consisted of single cells and aggregates of uniform malignant cells, forming microadenoid structures, branching, papillary clusters with delicate fibrovascular cores and nuclear overlapping. Naked capillaries were also seen. The nuclei of malignant cells were round or oval, eccentric with fine granular chromatin, small nucleoli and nuclear grooves in some of them. The malignant cells were periodic acid Schiff (PAS)-Alcian blue (+) and immunocytochemically they were vimentin (+), CA 19.9 (+), synaptophysin (+), chromogranin (-), neuro-specific enolase (-), a1-antitrypsin and a1-antichymotrypsin focal positive. Cytologic findings were strongly suggestive of SPTP. Biopsy confirmed the above cytologic diagnosis. EUS-guided FNA diagnosis of SPTP is accurate. EUS findings,rncytomorphologic features and immunostains of cell block help distinguish SPTP from pancreatic endocrine tumors, acinar cell carcinoma and papillary mucinous carcinoma.
机译：我们描述了由内镜超声引导（EUS引导）细针抽吸术（FNA）诊断的胰腺实体假乳头状瘤（SPTP）的临床，影像学和细胞病理学特征。一名17岁的妇女因内科诊所因原因不明的发作性腹痛持续2个月且高血压病史短而入院。临床实验室检查显示多囊卵巢综合征，脾肿大，血清淀粉酶和癌胚抗原（CEA）水平低。计算机断层扫描（CT）分析显示，胰腺尾部有大量固体和囊性稠度。 EUS证实了胰腺体和尾部的肿块，边界明显，这导致胰管外围部分扩张（大直径3.7 mm）。病人接受了EUS-FNA。 EUS-FNA细胞学标本由单个细胞和均匀的恶性细胞聚集组成，形成微腺样结构，分支，乳头簇，具有纤细的纤维血管核心和核重叠。还可以看到裸毛细血管。恶性细胞核为圆形或椭圆形，偏心，细颗粒染色质细，核仁小，部分核槽。恶性细胞为高碘酸席夫（PAS）-阿尔辛蓝（+），免疫细胞化学分析为波形蛋白（+），CA 19.9（+），突触素（+），嗜铬粒蛋白（-），神经特异性烯醇化酶（-），a1 -抗胰蛋白酶和α1-抗胰凝乳蛋白酶灶性阳性。细胞学检查结果强烈提示SPTP。活检证实以上细胞学诊断。 EUS指导的SPNA的FNA诊断是准确的。 EUS的发现，细胞形态学的细胞形态学特征和免疫染色有助于将SPTP与胰腺内分泌肿瘤，腺泡细胞癌和乳头状粘液癌区分开。

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